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Her PhD is looking into longitudinally phenotyping the microbiome of children with chronic suppurative lung disease. We had a chat with her to discuss her research.

You trained as a doctor but now you're completing a PhD in research. What attracted you to research?

I feel that if you really want to make a contribution to advancing paediatrics then getting involved in research is one of the best ways to do that.

Whilst at medical school, I completed an intercalated BSc in Psychology and greatly enjoyed the research I undertook during that time. The research I did as part of my BSc had much more of a face-to-face component, and I was keen to learn some new skills in the lab. During my Paediatric training, I developed an interest in Respiratory Medicine, particularly cystic fibrosis and respiratory infections. Then the opportunity to do this PhD came up whilst as I was an Senior House Officer (SHO) here at the Royal Brompton and it sounded like such an interesting topic that I really wanted to do.

Tell us about the research you’re doing

I’m looking at communities of bacteria in the lung. Until a few years ago it was believed that the lungs are sterile in healthy people. But there are newer techniques that have been developed to identify bacteria by sequencing their genes rather than trying to grow them on bacterial cultures.

By looking at a particular gene that all bacteria have, called the 16S rRNA gene, we are able to identify many more bacteria in different parts of the body than we've previously been aware of on bacterial cultures alone. Using these techniques, researchers found that even in healthy people the lungs aren’t sterile. There is almost an equivalent number of bacteria in the lungs as there are in the upper two thirds of the gut. So the question really is how is this influencing health and disease?

The diseases I'm looking at are Cystic Fibrosis (CF) and Primary Ciliary Dyskinesia (PCD). For the past 2 years, I've collected samples from patients coming in for routine hospital appointments. These include sputum, throat and cough swabs and occasionally bronchoscopy samples.

Using these samples, I'm aiming to track how bacterial communities in the lungs change and develop in different age groups with these conditions over time and how that correlates with changes in their disease progression. So for example, are there different bacteria that seem to proliferate at a time when children become particularly unwell with their disease?

CF in particular is a disease where the course tends to be quite up and down. There will be periods where the children are well and then there will be periods where they will have an exacerbation. One of my aims is to identify the changes in the bacterial communities between periods where children feel well and when they experience an exacerbation.

How do you think this research will impact on patient care?

This is an observational study so at the moment we are gathering information about which bacteria are present at different points during the disease course of CF and PCD.

I'm hoping that if we can identify specific changes in the bacterial community between periods of stability and exacerbations, in the future this may lead to different and new treatment strategies for maintaining lung health. For example, by developing probiotics to promote “good” bacteria or using different antibiotic strategies to those we currently use.

In CF in particular we know that as children have more exacerbations it tends to affect their quality of life and their life expectancy. With new born screening for CF a lot of children have better life expectancies already but we’d like to make this even longer.

You've almost completed your project - do you see yourself continuing to work in research?

I've really enjoyed doing my PhD but I've been told that writing my thesis might change my mind about that! But as I said, I feel that if I'm going to contribute to the advancement of medicine in the future then research is the best way to do that.

I've also really enjoyed working with children with CF and PCD and their families and it would be nice to be able to find something that could perhaps help them have more periods where they feel well and are able to do all the things they enjoy.